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BNF palliative care section updated

18th December 2012

The online BNF(December 2012) Palliative care section has been reorganised and now includes new tables for opioid conversions. The new pain management with opioids section has been organised to provide guidance on specific routes for pain management. The Equivalent doses of opioid analgesics table has been expanded to include more drugs and routes; also included is a new buprenorphine table and updated fentanyl patch conversion table.

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Alfentanil 5mg/mL supply problem

13th December 2012

There is a supply problem with high strength alfentanil 5mg/mL injection (Rapifen Intensive Care; Janssen-Cilag), due to a manufacturing issue. It is hopeful that the stock situation will resume by February 2013. Janssen-Cilag have an extremely limited supply available for emergency use. The prescriber must complete an emergency order form and discuss their requirements with the Janssen-Cilag medical team. For more details contact customer services (0800 7315550).

The generic manufacturer Hamelyn has limited alfentanil 5mg/mL stock available which is restricted to NHS hospitals only.

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Haloperidol for psychosis-induced aggression or agitation

13th December 2012

A Cochrane review has been published on the use of haloperidol for rapid tranquilisation of psychosis-induced aggression or agitation.

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DTB Sativex in multiple sclerosis

13th December 2012

The latest Drug and Therapeutics Bulletin (DTB) examines the place of the cannabinoid product, Sativex (GW Pharma, UK) in multiple sclerosis.

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LCP independent review

4th December 2012

Following a round table discussion, Norman Lamb (Minister for Care and Support) is to appoint an independent chair to understand what lies behind the reports of poor quality care associated with the implementation of the Liverpool Care Pathway (LCP) in the media and oversee and validate the review work initiated by the National End of Life Care Programme, the Association for Palliative Medicine and Dying Matters. The results of the independent review will be reported next year.

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